Constipation in infants: causes, what to do, prevention

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11.10.2017

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baby, constipation, causes, prevention

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Normally, a newborn's bowels, especially those from birth to six weeks, should have bowel movements several times a day. This usually happens after every feeding. Sometimes it happens that a baby may not have bowel movements for a week. If your baby doesn't show any concern, you shouldn't worry either. In such cases, the reason for the absence of bowel movements is the almost complete absorption of breast milk. That is, a small amount of waste enters the intestines, and it will be emptied only when they accumulate in sufficient quantities. But if the lack of stool in an infant is accompanied by bloating and increased gas formation, he shows anxiety, cries and strains , then mothers need to take urgent measures - this is constipation !

What should a newborn's stool look like?

Typically, an infant's stool has a mushy consistency . Its color is yellowish-brown, close to mustard. Oxidizing in air, it becomes greenish. There is a smell, but it cannot be called very repulsive. If the mother feeds the baby with formula milk, then his stool becomes the consistency of thick puree and the intestines are emptied less frequently. Normally, if a child under 6 months of age receives only mother’s breast milk, bowel movements should occur from 1 to 8 times a day, after six months of life - 1-3 times a day. However, foreign researchers believe that these figures should not be taken too literally. When a child grows and develops normally, the frequency and consistency of his stool may vary, and mothers should not focus their attention on this.

Infant formula for constipation

An example of a formula that promotes regular soft stools is Nuutrilak Premium COMFORT.

Oligosaccharides are also added to infant formula. They also use gum for this. It is a natural source of polysaccharides (dietary fiber), which regulate intestinal motility. In addition, it has a beneficial effect on the colon microbiota and its diversity. All this contributes to regular soft stools in the child. An example of such a mixture would be Nutrilak Premium Antireflux.

In complementary feeding dishes, preference should be given to vegetables and vegetable purees. Dietary fiber and vegetable fiber should be present in the child’s menu.

Fruits and fruit purees are not main dishes. They can be used as a dessert or as an addition to porridge.

What causes defecation disorders?

Most often, constipation in infants is functional, that is, acquired (almost 90%). Arise due to lack of milk and improper diet of the nursing mother; with early transfer of a child to artificial formulas and a sudden change from one formula to another; in cases of drinking violations; in case of allergic reactions to components of milk or formula (for example, to cow's milk protein); malfunction of the thyroid gland; iron deficiency. Among the reasons we will also name dysbacteriosis, immaturity of the gastrointestinal tract and the baby’s central nervous system. The cause of bowel problems is often lactase deficiency - a deficiency of lactase, the enzyme that breaks down milk sugar (lactose). As a result, difficulties arise with the absorption of breast milk.

At the same time, constipation in infants can be organic, that is, congenital . They, as a rule, torment the baby from the very first days of life and are associated with various developmental anomalies. We can talk about narrowing the intestine and lengthening its section; intestinal infections; disturbance of intestinal motility due to weakness of its muscles; rickets (lack of vitamins D); cystic fibrosis; Down's disease; hypothyroidism; Hirschsprung's disease. Often, so-called organic constipation is provoked by various birth injuries. The reasons for delayed bowel movements sometimes lie in the gallbladder. For a number of reasons (both congenital and acquired), it may not work correctly, which leads to digestive disorders in infants.

How to help a child?

Firstly , review your diet and frequency of meals
.

Breast milk contains oligosaccharides (more than 130 types) that promote the formation of regular stool. The mother's diet also affects the baby's stool. Strong tea, blueberries, and starchy foods slow down intestinal motor function. It is better to exclude them.

Transient dysbiosis as a cause of constipation

A child is born with a sterile intestine, in which there is no microflora. Colonization by various microorganisms occurs during the first weeks of life. Including opportunistic pathogens, which initially prevail over beneficial bifidobacteria and lactobacilli and, when actively multiplying, can cause various diseases. But the sooner the baby attaches to the breast, the greater the chance of avoiding such a development of events. The fact is that mother's milk contains protective antibodies and other nutrients that stimulate the growth of beneficial microflora, while simultaneously suppressing the vital activity of pathogenic ones. But this does not happen so quickly, occupying a certain “transition” period, which is called transient dysbiosis .

Against the background of transient dysbacteriosis, infants may develop constipation. Their reason is precisely in the insufficient amount of beneficial microflora - after all, it is they that are responsible for the production of a substance that stimulates intestinal motility. Transient dysbacteriosis is also manifested by other symptoms: frequent bowel movements, change in color of stool, the appearance of undigested lumps in the stool, bloating, excessive flatulence (especially during bowel movements), intestinal colic, frequent regurgitation, oral thrush, allergic rash (namely toxic erythema). But if there are no complications and intestinal or skin infections, then (depending on the manifestations) probiotic preparations, antispasmodics, absorbents, and digestive enzymes are used. The drugs must be prescribed by a doctor.

Diseases and risk factors

Constipation in children can be caused by a number of diseases that directly or indirectly affect the digestive process.

Hirschsprung's disease

This disease is characterized by a congenital defect in the nerve endings of the colon. These nerve endings are necessary to regulate the contractile function of the intestines, due to which feces are transported. Due to the lack of nerve endings, the intestinal walls do not contract, thereby causing stagnation and accumulation of contents.

Celiac disease

Celiac disease, or celiac disease, is a chronic digestive and immune disorder that damages the small intestine. The disease occurs due to eating foods containing gluten. Gluten is a protein found primarily in flour products such as pasta, cookies, and bread.

This disease occurs due to genetic characteristics of a person, which lead to the inability of the intestines to absorb gluten and disrupt the process of formation of feces.

Spina bifida

A congenital spinal malformation, a type of neural tube defect, often combined with defects in the development of the spinal cord. The defect is an incomplete closure of the neural tube in an incompletely formed spinal cord, which leads to paralysis of the lower extremities, bowel and bladder dysfunction.

Hypothyroidism

Hypothyroidism or underactive thyroid gland. The thyroid gland is an organ that produces a large number of hormones that control the functioning of the body. If the gland does not produce enough hormones, a person experiences a number of symptoms, which include constipation.

Constipation can also be caused by other diseases that affect the digestion process in one way or another. These include various tumors pressing on the intestines, injuries to the brain and spinal cord, and diabetes.

A number of medications can also cause indigestion:

• Anticonvulsants;
• Preparations containing aluminum and calcium - antacids;
• A number of painkillers;
• Some antidepressants;
• Antispasmodics.

The importance of identifying constipation early

At the beginning of our article, we mentioned some signs of defecation disorders (the baby’s stomach is swollen, gases are released, he is restless and cries). In addition, the baby develops intestinal colic, he may refuse the breast or, conversely, constantly seek it. The latter is explained not by a whetted appetite, but by a desire to find peace. Crying is typical, accompanied by pulling the legs towards the tummy. Constipation is often accompanied by an increase in body temperature and even vomiting, which is explained by self-poisoning of the body with unresolved toxins. Vomiting is a very alarming sign; it can lead to dehydration, which can lead to complications in the cardiovascular system. If measures are not taken, dysbiosis and serious pathologies of the gastrointestinal tract may develop.

It is clear that it is better not to bring the problem to such a development. Therefore, it is important to recognize constipation at the stage when it is just beginning to make itself known. The first signs are: the child has not had a bowel movement for two days, before defecation he strains for a long time, even to the point of redness, and the stool has a hard consistency (sometimes with blood). If a mother detects at least one of the above symptoms in her child, she must consult a doctor. It is possible that no special treatment will be needed and the problem can be dealt with on your own. But without doing anything on your own, following all the doctor’s instructions, while acting very carefully so as not to aggravate the situation. Below we will tell you about methods for treating constipation in babies at home.

Psychosomatics for constipation

If the child is only a month old, he will not experience constipation of psychosomatic origin. The central and autonomic nervous systems must mature to fully regulate intestinal function. Psychosomatics as the cause of constipation can be assumed in a child aged a year and a half or older, that is, at the time when he begins to be potty trained. Constipation for psychosomatic reasons can occur if:

• the baby has already experienced pain during bowel movements and is afraid of its repetition, so he holds back stool;
• parents force the child to sit on the potty, but this is unpleasant and scary for him;
• parents scold or punish the child for dirty and wet pants;
• there is an unfavorable emotional situation in the family, poor relationships between parents, a negative attitude towards the child;
• the child went to kindergarten or changed children's group. Constipation can be caused both by stress and by the fact that the baby is embarrassed to go to the potty in the presence of other children and other adults (teachers, nannies).

Almost all children experience constipation. For some these are isolated cases, for others they are regular. Parents should know what can cause constipation and how to deal with it.

So

1. To help a child with constipation, first of all, sufficient fluid intake will help: in the form of an additional portion of water, both before and during the period of introducing complementary foods. You cannot use medications, enemas, or folk remedies without a doctor’s prescription.
2. To prevent and treat constipation, it is worth mastering tummy massage techniques: circular, counter strokes and stroking the lateral sections of the abdomen.
3. Constipation in a mother can cause the same digestive problems in a breastfed baby.
4. Rotavirus infection can also cause constipation in a child.
5. The period of increased risk of constipation is the introduction of complementary foods.
6. During teething, constipation can be caused by poor appetite and loss of moisture due to increased body temperature.
7. Prophylactic doses of vitamin D3 do not cause constipation, unlike an overdose.
8. Psychosomatics as a cause of constipation begins to play a role when the child reaches the age of potty training, that is, from a year and a half and older.

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What can you do at home?

You should start with massage and physical therapy techniques . This stimulates intestinal peristalsis. Place your baby on his tummy before feeding. The massage is also carried out before feeding: circular movements on the tummy in a clockwise direction are recommended. After the “meal”, do not put the child to bed immediately - hold him in what is called a “column”, that is, vertically. There is no need to throw it in the palm of your hand, as many people do, as it can provoke a burp. To stimulate the intestines and the release of gases, straighten your baby's legs and at the same time bend them towards the tummy. Repeat 10-15 times, pressing firmly onto the area below the ribs. Then do the same, but with each leg separately. If the baby holds his head well, take it under your knees and hold it over the diaper or toilet.

Have you already introduced complementary foods into your child's diet? This may help combat constipation. Carrots, zucchini, pumpkin are natural laxatives . But mashed potatoes and cereals are not suitable in such cases, they “fix” the intestines. Suitable as a laxative are dried apricots, as well as prunes, but only from 5 months of age. Stimulation of the anus is effective in the fight against constipation. Insert a cotton swab lubricated with Vaseline , but shallowly, 1 cm, and carefully rotate. gas tubes help with constipation and colic. They are inserted to a depth of no more than 3 cm. There is an opinion that frequent use of tubes is addictive. Some people agree with this statement and others do not, but experts recommend not to abuse them.

None of these methods work? Then adopt a “radical” method - an enema . Pre-boil the rubber bulb, then fill it with water at room temperature and lubricate the tip with Vaseline. Remember: you cannot use soap, especially laundry soap, for lubrication; it can burn the baby’s delicate mucous membranes. Having laid the baby on its side and bending its legs at the knees, insert the tip of the bulb 2 cm into the anus and slowly release the water. It is advisable that at this moment someone helps you hold the baby. After the procedure, he must lie down: hold his buttocks for another 2-3 minutes. An alternative to an enema is a rectal suppository with glycerin . Divide it into 4 parts, round it with your fingers and insert one, making sure that the baby does not push it out.

Treatments to be used with caution

As an emergency measure, you can resort to microenemas or cleansing enemas. However, these methods cannot be used on a regular basis, since they do not treat the cause, but they can become addictive: with their frequent use, children often begin to have bowel movements only after stimulation of the anus.

Previously, in the treatment of constipation, choleretic and enzyme preparations were often prescribed, and additional probiotics were recommended. To date, the lack of effect from their use has been proven.

When you can't do without medical help...

Unfortunately, not in all cases you can cope with constipation on your own. If defecation disorders are accompanied by severe pain in the tummy, the baby refuses to eat, his stomach is very swollen, and blood is found in the stool, immediately go to the doctor . He may prescribe laxatives, which are still best not to get carried away with (as well as enemas). If the cause of constipation is dysbacteriosis, then the pediatrician will prescribe drugs to restore the microflora (for example, Biocomplexes Normoflorins). After examining the child, the doctor may refer you to other specialists, for example, an endocrinologist or urologist. The causes of constipation often have an emotional and psychological component (perhaps something scared the baby, he was stressed). In this case, you will need the help of a neurologist.

Constipation during teething

Any number of undesirable effects - from a runny nose to an increase in temperature - are not associated with teething. Constipation, like diarrhea, is also among these symptoms. Is it really? Yes and no. The eruption of a tooth from the gum itself, of course, does not cause constipation. However, itching and pain in the place where the tooth is cut bother the baby, his appetite decreases and the temperature may even rise, which leads to increased moisture consumption. The baby eats and drinks less well, which means he poops less often. His stool may become drier and denser due to lack of fluid.

Ways to prevent constipation in infants

The occurrence of problems with bowel movements is often influenced by the incorrect diet of a nursing mother . It is enough for her to include more vegetables and bread with bran in her food , eat prunes and consume fermented milk products (kefir, yogurt) , and the baby’s constipation will go away on its own. But white bread, rice, bananas, coffee and nuts, as well as gas-forming grapes and cabbage should be excluded from the diet.

Bran helps fight constipation - not only in the baby, but also in his mother. Take a tablespoon of them 3 times a day before meals. If your baby is bottle-fed, then it is better to entrust the prevention to a pediatrician. Perhaps he will advise replacing the regular milk formula with a medicinal one. He will also prescribe fermented milk mixtures for your baby.

Don’t rush to introduce baby foods into your diet. He can also cause constipation because at a very early age his body does not have enzymes to digest food other than milk. After 5-6 months, he can be given porridge from fiber-rich whole grains, they will improve intestinal motility. It is also important that the child drinks enough water.

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Mother's diet and formula selection

For breastfed babies, the problem of constipation can be solved by changing the mother's diet. It is necessary to exclude products that have a fixing effect, which are described above, and add to the daily menu products that give laxative properties to mother's milk.

Products that improve newborn digestion:

• fresh vegetable salads containing dill, parsley, seasoned with vegetable oil, preferably olive oil;
• porridge (buckwheat, oatmeal, pearl barley);
• vegetable broth soups;
• white poultry meat;
• prunes;
• dried apricots;
• boiled beets and pumpkin;
• natural unsweetened yogurt, kefir.

If a bottle-fed baby experiences constipation, then you should think about replacing the formula. You can try fermented milk mixtures from Nan, Nutrilon or Nutrilak.

Mothers who bottle-feed their babies should remember that formulas require additional supplementation with water. It should be given at the rate of 10 ml (2 teaspoons) per 1 month of life per day.

Features of the children's diet

All pediatricians in the world agree that there is no better nutrition for a baby than mother's milk. Dr. Komarovsky cites the following benefits of breastfeeding:

• optimal food temperature;
• ideal food purity;
• minimal risk of allergic reactions, gastrointestinal disorders;
• the presence in milk of additional beneficial substances necessary for the full development of the child’s body**.

And the composition of mother's milk changes over time, and not for the worse. The older the child, the higher the percentage of fat content and the amount of vitamins. This food perfectly satisfies the baby's needs**.

Long-term breastfeeding will benefit not only the child, but also his mother: a 2002 study by the Collaborative Group on Hormonal Factors in the Development of Breast Cancer showed that breastfeeding reduces the risk of developing cancer of the female reproductive system and mammary glands***. However, not all women are able to breastfeed. If the mother cannot feed the baby with her own milk, you just need to choose a suitable formula for the newborn together with the pediatrician. Fortunately, the modern market offers a lot of options for artificial feeding.

Symptom elimination

In children, constipation (in 95% of cases) is functional in nature. If organic constipation is suspected, it is necessary to conduct an examination as soon as possible in order to determine the treatment tactics for the underlying disease, the symptom of which is coprostasis. Treatment can be either conservative or surgical.

Treatment of constipation in a child 1 month of age should be prescribed by a pediatrician. During a clinical examination, the doctor pays attention to the color of the baby’s skin, the presence of plaque on the tongue, and the shape and size of the abdomen. After an examination and medical history, the doctor will select the most appropriate medication and determine the required dosage, and if necessary, prescribe additional studies.

Treatment of coprostasis depends on the etiology of the disease, concomitant diseases, and the nature of the disturbance in the motor activity of the large intestine. To speed up peristalsis, the baby may be prescribed drugs based on lactulose or suppositories with glycerin.

The goal of therapy is to restore the consistency of stool and normalize the speed of movement of intestinal contents through the large intestine

Lactulose is not absorbed or digested in the small intestine, but enters the large intestine, where it becomes food for intestinal bacteria that break down carbohydrates. The disaccharide increases the number of lacto- and bifidobacteria. Lactulose is an osmotic laxative, meaning it promotes water retention in the intestines, which increases the volume of feces and activates intestinal motility.

The drug can be used for a long time, even from the first days of life, since it is not addictive and safe for the baby. The therapeutic effect appears within 1–2 days after starting to take the drug. Since bacteria in the intestines begin to actively multiply, the baby may experience increased gas production, so some pediatricians recommend starting with small doses and gradually increasing them.

Lactulose is an active ingredient in the following drugs:

Suppositories for constipation with glycerin

• Bioflorax;
• Good luck;
• Duphalac;
• Lactuvit;
• Lactulax;
• Lizalak;
• Normaze;
• Normolakt;
• Flowlac 100 and others.

Suppositories with glycerin can also speed up the process of bowel movements. In addition to glycerin, they contain sodium carbonate and stearic acid. Glycerin coats the intestinal walls, which facilitates easier passage of feces; in addition, the substance softens feces and activates intestinal motility.

The product is not absorbed into the bloodstream, is not addictive and is safe for infants. The effect of a candle with glycerin occurs within half an hour. As a rule, suppositories are used from the age of three months, however, if necessary, the pediatrician can recommend the remedy for a month-old baby, but it will need to be divided into two or three parts.

For spastic constipation, children can be prescribed antispasmodics (a course of 3–5 days), contact heat, warm relaxing baths, suppositories with belladonna, novocaine, papaverine, which provide an analgesic, antispasmodic and anti-inflammatory effect. For atonic constipation, B vitamins, prokinetics, and nootropics may be recommended.